Document Detail

Compartment Pressure Measurements Have Poor Specificity for Compartment Syndrome in the Traumatized Limb.
MedLine Citation:
PMID:  23321294     Owner:  NLM     Status:  Publisher    
BACKGROUND: Osseofascial compartment syndrome is defined by ischemic necrosis of muscle caused by elevated pressure within fascial compartments. The diagnosis can be made either clinically or through compartment pressure measurements. Compartment pressure above 30 mm Hg was traditionally used as the threshold for diagnosis of compartment syndrome, but was challenged due to a high number of false-positive results. Perfusion pressure (diastolic blood pressure - compartment pressure) <30 mm Hg came to be promoted as a confirmatory diagnostic test. OBJECTIVE: The objective of this article is to review the specificity of perfusion pressure for compartment syndrome in the acutely traumatized limb. DISCUSSION: Perfusion pressure has been shown to generate false-positive results in 18-84% of patients with tibial fractures. Two studies showed that not a single patient with measurements qualifying for fasciotomy actually needed the procedure. CONCLUSION: Both absolute compartment pressure and tissue perfusion pressure generate a high rate of false-positive results in the acutely traumatized limb. An alternative diagnostic test or process is needed to prevent overtreatment. In the meantime, emergency medicine and orthopedic surgery textbooks and guidelines should promote awareness of the limitations of the test.
James A Nelson
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-12
Journal Detail:
Title:  The Journal of emergency medicine     Volume:  -     ISSN:  0736-4679     ISO Abbreviation:  J Emerg Med     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8412174     Medline TA:  J Emerg Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Elsevier Inc. All rights reserved.
Emergency Department, Pioneers Memorial Hospital, Brawley, California and Department of Emergency Medicine, University of California at San Diego Medical Center, San Diego, California.
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